支气管封堵器应用于儿童肺包虫囊肿手术对动脉血气指标、肺萎陷情况和肺不张发生率的影响

目的探究支气管封堵器应用于儿童肺包虫囊肿手术对动脉血气指标、肺萎陷情况和肺不张发生率的影响。 方法选取肺包虫囊肿手术患儿63例为研究对象，基于随机数字表法分为对照组30例和研究组33例。对照组术中应用双腔支气管导管法进行通气，研究组术中应用支气管封堵器进行通气。比较2组动脉血气指标［动脉血二氧化碳分压（partial pressure of carbon dioxide，PaCO2）和动脉血氧分压（partial pressure of oxygen，PaO2）］、肺萎陷优良率、住院时间、肺不张发生率和胸部浸润影发生率。 结果2组PaO2均呈逐渐降低趋势，PaCO2均呈逐渐升高趋势，研究组PaO2低于对照组，PaCO2高于对照组，组间、时点间、组间·时点间交互作用差异均有统计学意义（P＜0.05）。2组单肺通气20 min时术中肺萎陷优良率高于同组单肺通气10 min时，单肺通气30 min时术中肺萎陷优良率高于同组单肺通气10 min和单肺通气20 min时；研究组单肺通气30 min术中肺萎陷优良率显著高于对照组，差异有统计学意义（P＜0.05）。2组术后住院时间、肺不张发生率及胸部浸润影发生率差异均无统计学意义（P＞0.05）。 结论支气管封堵器应用于儿童肺包虫囊肿手术能有效改善动脉血气功能，提高术中肺萎陷优良率，其安全性较高，对肺不张发生率的影响较小。

Effect of bronchial blocker on arterial blood gas index,lung collapse and incidence of atelectasis in children undergoing surgery for pulmonary hydatid cyst

ObjectiveTo explore the effect of bronchial blocker(BB) on arterial blood gas index, lung collapse and incidence of atelectasis in children undergoing surgery for pulmonary hydatid cyst(PHC).MethodsA total of 63 children undergoing surgery for PHC were selected as the research subjects, and they were divided into the control group(n=30) and the research group(n=33) based on the random number table method. The control group was ventilated with a double-lumen bronchial catheter during surgery, and the research group was ventilated with a BB during surgery. Arterial blood gas indexes［partial pressure of carbon dioxide(PaCO2) and partial pressure of oxygen(PaO2)］, excellent and good rate of lung collapse, length of hospital stay, incidence of atelectasis and chest invasion were compared between two groups.ResultsPaO2 in the two groups showed a gradual decrease, while PaCO2 showed a gradual increase. The PaO2 was lower while the PaCO2 was higher in the research group than in the control group. There were statistical differences in interaction between groups, time points, and time points between groups(P＜0.05). The excellent and good rate of intraoperative lung collapse at 20 min of single-lung ventilation in the two groups was higher than that of the same group at 10 min of single-lung ventilation, and the excellent and good rate of intraoperative lung collapse at 30 min of single-lung ventilation was higher than that of the same group at 10 and 20 min of single-lung ventilation. The excellent and good rate of lung collapse in the research group was significantly higher than that of the control group at 30 min of one-lung ventilation, and the difference was statistically significant(P＜0.05). There was no significant difference in the postoperative hospital stay, the incidence of atelectasis and chest infiltration between two groups(P＞0.05).ConclusionThe BB used in surgery for PHC in children can effectively improve the arterial blood gas function and increase the excellent and good rate of lung collapse during surgery. It is safer and has less impact on the incidence of atelectasis.